Wellcome Open Research

FluSurvey is a participatory surveillance system used to monitor trends in influenza and other respiratory viruses through weekly symptom surveys among the UK population. We aimed to characterise the wider impact of "influenza-like illnesses" (ILI) among FluSurvey participants and assess correlations of ILI with other established influenza surveillance systems. We included data reported by FluSurvey participants over the 2023-24 and 2024-25 winter seasons. Using weekly symptoms surveys, we deri...

ObjectivesDiagnosis of community-acquired Legionnaires disease (CALD) relies on microbiological testing. Routine testing in hospitalised CAP patients has low positivity rates. We externally validated a Legionella prediction score, assessed its applicability in routine care, and explored potential updates. MethodsWe analysed data from 196 CALD patients from 20 Swiss hospitals and 196 Legionella-negative CAP controls matched by date of diagnosis ({+/-}14 days; August 2022-March 2024). We assessed...

Background and objectivesDiagnostic disclosure practices for autosomal dominant polycystic kidney disease (ADPKD) vary and may influence patient experience and linkage to nephrology care. We characterized patient-reported diagnostic pathways, perceived timing, and disclosure experiences in the PK-DIAG survey. Design, setting, participants, and measurementsCross-sectional web-based survey in France (February 2019-August 2024) among adults with self-reported ADPKD, disseminated via patient organi...

BackgroundImmune checkpoint inhibitor (ICI)-associated acute interstitial nephritis (ICI-AIN) has emerged as a common cause of acute kidney injury (AKI). However, acute tubular necrosis (ATN) may present with similar clinical features yet requires fundamentally different management. Robust data on the prevalence of ATN among patients with suspected ICI-AIN are limited. The aim of this study was to determine the prevalence of ATN in patients with suspected ICI-AIN and to estimate the risk of diag...

BackgroundRecurrent sore throat affects a small minority of adults but can cause substantial morbidity. Evidence to guide tonsillectomy eligibility in adults is limited, and current criteria are extrapolated from paediatric populations. We aimed to describe the epidemiology, management, and prognosis of adult sore throat in UK primary care. MethodsUsing CPRD Aurum (2010-2020 adults with a first coded episode of sore throat or tonsillitis were identified and matched to controls. Episode frequenc...

ImportanceRecent reports have highlighted an intense influenza activity related to the circulation of the influenza A(H3N2) subclade k variant. There is no data available on the impact of the emergence of H3N2 subclade k on the severity of the 2025-2026 epidemic or on the clinical phenotype of patients requiring admission to the intensive care unit (ICU). ObjectiveTo compare the clinical presentation, hospital mortality and virological characteristics of patients with laboratory-confirmed influ...

BackgroundThe United Nations General Assembly High-level Meeting on Antimicrobial Resistance (UNGA HLM-AMR) committed to a target that 70% of global human antibiotic use (ABU) should be from the Access group of the WHO AWaRe system. MethodsWe used 2019 IQVIA MIDAS(R) global ABU Quarterly value sales, volumes (kg/SU) and average ex-manufacturer prices to evaluate price per daily defined dose (DDD) by AWaRe group across countries. IQVIA MIDAS volumes/value data reflect public, private, or mixed s...

The growth of generative AI and easily available Open Access health datasets has transformed researcher productivity, leading to an explosion in publications that has in part been attributed to paper mills (organisations that provide manuscripts for payment) and other unethical actors. These entities are not, however, homogenous, and have a range of products and target markets. While the demand from China has received much attention, here we provide a case study of CDC WONDER, a dataset that has...

Social prescribing (SP) is growing rapidly in the United Kingdom and internationally. However, the evidence for its impact is still limited. Drawing pre-post data from longitudinal administrative records (n=4,547), this study aimed to investigate whether SP has the potential to reduce health service utilisation in both primary and secondary care settings. The outcomes were measured using self-reported GP visits, A&E attendances and hospital admissions in the last three months. Data were analysed...

BackgroundClimate change is increasingly recognised as a threat to population health and healthcare systems, yet the effects of environmental variability on pharmaceutical prescribing remain poorly characterised in the UK. Using a wide array of open-source datasets, we examine the effect of environmental, geographic and socioeconomic factors on prescribing habits in England. MethodsWe linked monthly, practice-level prescribing data for England (2010-2025) to meteorological, air-quality, floodin...

IntroductionDepression is highly prevalent among young adults worldwide. While research links health behaviours, such as dietary intake, to depression, few studies have examined these associations among young adults in low- and middle-income countries, including South Africa. This study investigated whether dietary intake was associated with an increased risk of depression in a cohort of young South African adults, aged 20-30 years, as part of the Global burden of disease Lifestyle And mental Di...

An understated disruption to health services brought about by the Covid-19 pandemic was the increase in deaths occurring outside a hospital. Since quality of end-of-life care is typically monitored through place of death and hospital activity, a new approach focused on care in community settings is needed. In this study, we aimed to test whether patient-centric measures of quality at the end of life can be derived from primary care electronic records. With the approval of NHS England, analysis ...

IntroductionGrowing evidence suggests pesticide exposure can affect emotional well-being; limited research exists across adolescence and young adulthood. We examined cross-sectional and longitudinal associations of pesticide biomarkers with anxiety and depression scores. MethodsWe analyzed 646 participants from Ecuadorian agricultural communities: 510 in 2016 (ages 11-17y) and 485 in 2022 (17-24y). Twelve urinary insecticide metabolites were measured. Validated questionnaires assessed depressio...

BackgroundSleep regularity plays a significant role in mental health, but its association with anxiety or depression symptoms in midlife and whether movement behaviors moderate these associations is unclear. We examined how variability in sleep timing and duration is associated with these symptoms and tested the moderating effects of physical activity and sedentary time. MethodsWe analyzed data from 3,556 46-year-old participants in the Northern Finland Birth Cohort 1966. Sleep regularity was d...

BackgroundThe COVID-19 pandemic was strongly shaped by the interaction between population behaviour and transmission dynamics. Standard mathematical models do not account for this interaction, however. Objectivewe tested whether adding a mechanistic representation of population behavioural dynamics improves the ability of a mathematical model to explain and predict COVID-19 pandemic waves. MethodsWe compared a standard Susceptible-Infected-Recovered (SIR) model to a variant (SIRx) with a mecha...

BackgroundDuring the early phase of the Covid-19 pandemic in England, people with pre-existing conditions that put them at severe clinical risk if infected were advised to drastically reduce face-to-face contacts in a policy known as "shielding". The impact of this policy in preventing COVID-19 hospitalisations and deaths has not been evaluated at the national level using transmission-dynamic modelling. MethodsWith the approval of NHS England, we present a retrospective cohort evaluation of the...

BackgroundDetermining the impact of preventive interventions on future health and economic outcomes in a given population often requires parameterising disease models with forecast disease incidence, remission and case fatality rates. This paper outlines a method to specify these forecasts, using period estimates over several years from source data that are not necessarily coherent from a cohort perspective. MethodsFor a given chronic disease, the model is specified by first obtaining and smoot...

Automated outbreak detection can enhance infectious disease surveillance by enabling early identification of outbreaks and supporting timely public health measures. However, information on its current use by national public health institutes (NPHI) remains limited. This paper provides an updated and extended overview of automated outbreak detection usage in the European Union (EU) and United Kingdom (UK). Key findings were gathered through the Joint Action United4Surveillance via an online surve...

BackgroundSmoking, unhealthy nutrition, alcohol consumption, and physical inactivity (SNAP behaviours) are major risk factors for multimorbidity but are often studied in isolation. Using longitudinal data, Suhag et al. identified clusters of older adults (aged [≥]50) with common SNAP behaviour patterns and distinct sociodemographic profiles and multimorbidity prevalence; whether and how these patterns generalise across adulthood remains unclear. AimTo conceptually replicate Suhag et al. acro...

Understanding the burden of pertussis and pertussis-related mortality is important in enabling better understanding of population vulnerability and supporting vaccination programme planning. However, changes in laboratory practice can have important implications for public health surveillance. This study considers the impact of increasing use of multiplex panel testing for respiratory pathogens on ascertainment of pertussis-related deaths, drawing on multiple surveillance data sources from Engla...